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Public health educators, scientists and practitioners alike celebrate Dr. Anthony Fauci, who announced his intention to leave government service this week. As director of the National Institute of Allergy and Infectious Diseases for 38 years, Dr. Fauci has been front-and-center during the most challenging threats to public health — from the HIV/​AIDS epidemic to the COVID-19 pandemic.

Now, more than ever, it is vital that public health takes the lead to counter health threats at every level of our common society — from continent to country, from state to county and from city to neighborhood. We know how to do this. Unfortunately, our recent efforts — often reactive — continue to fall short. Of greatest risk are our most vulnerable populations—the poor and disenfranchised.

What will it take to protect them? Community protection requires accomplishing three imperatives:

First, we must invest in our public health infrastructure, the floor of public health’s home. The three pillars of this floor are:

(1) A well pre-prepared future front line of public health professionals,

(2) Effectively functioning federal, state and local health agencies, and

(3) Global surveillance and data management systems to accelerate just-in-time responses during current pandemics, and to the re-emergence of old foes like polio, recently reported in New York.

The U.S. Centers for Disease Control and Prevention (CDC) is the country’s leading public health agency and the primary source of funding for state, local, tribal and territorial health departments. CDC’s annual funding for Public Health Emergency Preparedness (PHEP) programs increased slightly between fiscal years 2021 and 2022 ($840 million to $862 million) but has been reduced by more than a fifth since fiscal year 2002 — approximately by half when adjusted for inflation. Lacking 50% of its capacity hampered our response, contact tracing and prevention during the COVID-19 pandemic. Last week, CDC outlined specific plans focused on collaboration and workforce training, expedited release of data and simplified guidance to provide clearer communication. These are important steps forward.

However, without sustained funding, no reorganization will be effective.

In addition to a fragile public health infrastructure resulting from decades of underfunding federal, state and local health agencies, the COVID-19 pandemic response violated the golden principle of crisis communication: be first, be right, be credible. For a myriad of reasons, the public health voice was not the first to be heard (though, thankfully, Dr. Fauci filled that void). Public health science guidelines were often called into question, ultimately endangering the global credibility that CDC and other public health leaders historically enjoyed. We must recommit to this communication paradigm.

The third — and perhaps most pivotal — imperative to address complex public health threats is using a collaborative approach across the health sciences, including public- and private-sector responders, and proactively engaging all communities, especially those at greatest risk of adverse health effects. An understanding of the necessity of collaboration was delayed during the pandemic, resulting in cascading front line action delays and exacerbating negative consequences to health among the poorest.

For decades, schools of public health have served as a neutral and natural convener of stakeholders and other necessary partners to ensure that communities are at the center of every action and investment. At Pitt Public Health, our mission of education, research and practice ensures we are ready to protection our communities every day, not just during crises. We have set forth three interconnected priorities for countering pandemics, persistent disparities and urgent health threats:

(1) Advancing precision public health research and taking a tailored approach to unraveling cumulative health risks facing the most vulnerable communities, including right here in Pittsburgh,

(2) Addressing climate change as the most urgent health threat facing each one of us, and

(3) Creating a diverse pipeline of emerging public health leaders encompassing students and faculty.

More specifically, the response to the COVID-19 pandemic has shown us that a one-size-fits-all approach led to more hospitalizations and deaths among those most vulnerable — the elderly, underrepresented minorities and the economically disadvantaged. Precision public health demands a tailored, community-engaged approach to address public health threats.

COVID and climate change have much in common. Despite an abundance of scientific evidence, the threat of climate change is underestimated and often ignored. At the same time, misinformation erodes any sense of urgency to take action. Furthermore, the more we intrude into the habitats of animals, including mosquitoes and bats, the greater our risk of animal-to-human transmission of diseases not previously encountered by humans, spurring the development of future epidemics and potential pandemics.

An effective, sustained response — and above all readiness — requires a competent public health workforce. To create a cadre of emerging public health leaders, we must begin at the earliest possible time. Just this week, Pitt Public Health welcomed its inaugural Bachelor of Public Health class. These students can look forward to a bright future as they learn about the importance of public health and team with people in our communities. They will soon be joined by high schoolers who recently graduated from our public health science academy.

Public health is the front line, full stop. It’s much cheaper and more efficient to prevent disease and to manage risks at the population level than it is to address complex, advanced stage disease at the individual level. In other words, public health must be ready, and allowed, to lead during the next pandemic. We have effectively done so in the past and can reassume this role when bolstered by sustained investments in our frontline workforce, our science and our communities.

Maureen Lichtveld, M.D., M.P.H., is an environmental epidemiologist and dean of the University of Pittsburgh School of Public Health. She is a member of the National Academy of Medicine and has nearly 40 years of experience in environmental public health, including 18 years with the CDC.